Background: In the last confidential enquiries into maternal deaths  (CEMD)  reported medical disorder is the leading cause of  maternal death in Malaysia. Medical disorders in pregnancy can become life threatening and  jeopardized the maternal life, of such severity as to warrant termination of pregnancy (TOP). Unfortunately TOP itself associated with morbidity and mortality in this group of patients. Through pre pregnancy counseling  and effective contraceptive practice, unplanned pregnancy can be prevented hence unnecessary  complications related to the procedure could be avoided.

Objective: To analyse the medical indications for termination of pregnancy, pre pregnancy counseling   and contraceptive advice received among women who underwent  termination of pregnancy.

Methods: A retrospective  review of  all  termination cases performed for medical  indications following a multidiscipline meeting and family conference  in the Department of Obstetrics and Gynecology, Hospital Tengku Ampuan Afzan, Kuantan, Pahang from January 2016 to May 2017.

Results: From 13 termination cases, 6/13 (46.2%) were performed for medical indications, out of six cases, 4 (66.7%) were for cardiac and 2 cases  (33.3%) were for renal indication. Mean maternal age, 33.6 years (range 20-48); median gravidity, 3; and parity, 1; and mean gestational age, 15.6 weeks (range 10-22). Five cases (83%) were unplanned pregnancies, one case (16.6%) received Pre pregnancy counselling and one case (16.6%) practiced contraception. Terminations were primarily medical  n=5 (83.3%) rather than surgical n=1 (16.7%).

Conclusions: Cardiovascular disease appear to be the commonest medical indication for TOP and average gestational age were in the  second trimester. Pre pregnancy counseling and contraceptive rates in this at risk group appear to be poor and need urgent attention by the care provider.